Prognostic Value of Early Fluorodeoxyglucose-Positron Emission Tomography Response Imaging and Peripheral Immunologic Biomarkers: Substudy of a Phase II Trial of Risk-Adaptive Chemoradiation for Unresectable Non-Small Cell Lung Cancer
Purpose: We sought to examine the prognostic value of fluorodeoxyglucose-positron emission tomography (PET) imaging during chemoradiation for unresectable non-small cell lung cancer for survival and hypothesized that tumor PET response is correlated with peripheral T-cell function. Methods and Mater...
| Main Authors: | , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-03-01
|
| Series: | Advances in Radiation Oncology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2452109421002153 |
| _version_ | 1818338531017228288 |
|---|---|
| author | Stephen R. Bowen, PhD Daniel S. Hippe, MS Hannah M. Thomas, PhD Balukrishna Sasidharan, MBBS, MD, DNB, DMRT Paul D. Lampe, PhD Christina S. Baik, MD, MPH Keith D. Eaton, MD, PhD Sylvia Lee, MD Renato G. Martins, MD, MPH Rafael Santana-Davila, MD Delphine L. Chen, MD Paul E. Kinahan, PhD Robert S. Miyaoka, PhD Hubert J. Vesselle, MD, PhD A. McGarry Houghton, MD Ramesh Rengan, MD, PhD Jing Zeng, MD |
| author_facet | Stephen R. Bowen, PhD Daniel S. Hippe, MS Hannah M. Thomas, PhD Balukrishna Sasidharan, MBBS, MD, DNB, DMRT Paul D. Lampe, PhD Christina S. Baik, MD, MPH Keith D. Eaton, MD, PhD Sylvia Lee, MD Renato G. Martins, MD, MPH Rafael Santana-Davila, MD Delphine L. Chen, MD Paul E. Kinahan, PhD Robert S. Miyaoka, PhD Hubert J. Vesselle, MD, PhD A. McGarry Houghton, MD Ramesh Rengan, MD, PhD Jing Zeng, MD |
| author_sort | Stephen R. Bowen, PhD |
| collection | DOAJ |
| description | Purpose: We sought to examine the prognostic value of fluorodeoxyglucose-positron emission tomography (PET) imaging during chemoradiation for unresectable non-small cell lung cancer for survival and hypothesized that tumor PET response is correlated with peripheral T-cell function. Methods and Materials: Forty-five patients with American Joint Committee on Cancer version 7 stage IIB-IIIB non-small cell lung cancer enrolled in a phase II trial and received platinum-doublet chemotherapy concurrent with 6 weeks of radiation (NCT02773238). Fluorodeoxyglucose-PET was performed before treatment start and after 24 Gy of radiation (week 3). PET response status was prospectively defined by multifactorial radiologic interpretation. PET responders received 60 Gy in 30 fractions, while nonresponders received concomitant boosts to 74 Gy in 30 fractions. Peripheral blood was drawn synchronously with PET imaging, from which germline DNA sequencing, T-cell receptor sequencing, and plasma cytokine analysis were performed. Results: Median follow-up was 18.8 months, 1-year overall survival (OS) 82%, 1-year progression-free survival 53%, and 1-year locoregional control 88%. Higher midtreatment PET total lesion glycolysis was detrimental to OS (1 year 87% vs 63%, P < .001), progression-free survival (1 year 60% vs 26%, P = .044), and locoregional control (1 year 94% vs 65%, P = .012), even after adjustment for clinical/treatment factors. Twenty-nine of 45 patients (64%) were classified as PET responders based on a priori definition. Higher tumor programmed death-ligand 1 expression was correlated with response on PET (P = .017). Higher T-cell receptor richness and clone distribution slope were associated with improved OS (P = .018-0.035); clone distribution slope was correlated with PET response (P = .031). Conclusions: Midchemoradiation PET imaging is prognostic for survival; PET response may be linked to tumor and peripheral T-cell biomarkers. |
| first_indexed | 2024-12-13T15:12:35Z |
| format | Article |
| id | doaj.art-3fb66f4cd14d4b90978539f30c9d469e |
| institution | Directory Open Access Journal |
| issn | 2452-1094 |
| language | English |
| last_indexed | 2024-12-13T15:12:35Z |
| publishDate | 2022-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Advances in Radiation Oncology |
| spelling | doaj.art-3fb66f4cd14d4b90978539f30c9d469e2022-12-21T23:40:50ZengElsevierAdvances in Radiation Oncology2452-10942022-03-0172100857Prognostic Value of Early Fluorodeoxyglucose-Positron Emission Tomography Response Imaging and Peripheral Immunologic Biomarkers: Substudy of a Phase II Trial of Risk-Adaptive Chemoradiation for Unresectable Non-Small Cell Lung CancerStephen R. Bowen, PhD0Daniel S. Hippe, MS1Hannah M. Thomas, PhD2Balukrishna Sasidharan, MBBS, MD, DNB, DMRT3Paul D. Lampe, PhD4Christina S. Baik, MD, MPH5Keith D. Eaton, MD, PhD6Sylvia Lee, MD7Renato G. Martins, MD, MPH8Rafael Santana-Davila, MD9Delphine L. Chen, MD10Paul E. Kinahan, PhD11Robert S. Miyaoka, PhD12Hubert J. Vesselle, MD, PhD13A. McGarry Houghton, MD14Ramesh Rengan, MD, PhD15Jing Zeng, MD16Radiation Oncology and; Radiology, University of Washington School of Medicine, Seattle, WashingtonRadiology, University of Washington School of Medicine, Seattle, WashingtonDepartment of Radiation Oncology, Christian Medical College, Vellore, IndiaDepartment of Radiation Oncology, Christian Medical College, Vellore, IndiaHuman Biology Division, Fred Hutchinson Cancer Research Center, Seattle, WashingtonDivision of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WashingtonDivision of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WashingtonDivision of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WashingtonDivision of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WashingtonDivision of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WashingtonRadiology, University of Washington School of Medicine, Seattle, WashingtonRadiology, University of Washington School of Medicine, Seattle, WashingtonRadiology, University of Washington School of Medicine, Seattle, WashingtonRadiology, University of Washington School of Medicine, Seattle, WashingtonHuman Biology Division, Fred Hutchinson Cancer Research Center, Seattle, Washington; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WashingtonRadiation Oncology and; Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WashingtonRadiation Oncology and; Corresponding author: Jing Zeng, MDPurpose: We sought to examine the prognostic value of fluorodeoxyglucose-positron emission tomography (PET) imaging during chemoradiation for unresectable non-small cell lung cancer for survival and hypothesized that tumor PET response is correlated with peripheral T-cell function. Methods and Materials: Forty-five patients with American Joint Committee on Cancer version 7 stage IIB-IIIB non-small cell lung cancer enrolled in a phase II trial and received platinum-doublet chemotherapy concurrent with 6 weeks of radiation (NCT02773238). Fluorodeoxyglucose-PET was performed before treatment start and after 24 Gy of radiation (week 3). PET response status was prospectively defined by multifactorial radiologic interpretation. PET responders received 60 Gy in 30 fractions, while nonresponders received concomitant boosts to 74 Gy in 30 fractions. Peripheral blood was drawn synchronously with PET imaging, from which germline DNA sequencing, T-cell receptor sequencing, and plasma cytokine analysis were performed. Results: Median follow-up was 18.8 months, 1-year overall survival (OS) 82%, 1-year progression-free survival 53%, and 1-year locoregional control 88%. Higher midtreatment PET total lesion glycolysis was detrimental to OS (1 year 87% vs 63%, P < .001), progression-free survival (1 year 60% vs 26%, P = .044), and locoregional control (1 year 94% vs 65%, P = .012), even after adjustment for clinical/treatment factors. Twenty-nine of 45 patients (64%) were classified as PET responders based on a priori definition. Higher tumor programmed death-ligand 1 expression was correlated with response on PET (P = .017). Higher T-cell receptor richness and clone distribution slope were associated with improved OS (P = .018-0.035); clone distribution slope was correlated with PET response (P = .031). Conclusions: Midchemoradiation PET imaging is prognostic for survival; PET response may be linked to tumor and peripheral T-cell biomarkers.http://www.sciencedirect.com/science/article/pii/S2452109421002153 |
| spellingShingle | Stephen R. Bowen, PhD Daniel S. Hippe, MS Hannah M. Thomas, PhD Balukrishna Sasidharan, MBBS, MD, DNB, DMRT Paul D. Lampe, PhD Christina S. Baik, MD, MPH Keith D. Eaton, MD, PhD Sylvia Lee, MD Renato G. Martins, MD, MPH Rafael Santana-Davila, MD Delphine L. Chen, MD Paul E. Kinahan, PhD Robert S. Miyaoka, PhD Hubert J. Vesselle, MD, PhD A. McGarry Houghton, MD Ramesh Rengan, MD, PhD Jing Zeng, MD Prognostic Value of Early Fluorodeoxyglucose-Positron Emission Tomography Response Imaging and Peripheral Immunologic Biomarkers: Substudy of a Phase II Trial of Risk-Adaptive Chemoradiation for Unresectable Non-Small Cell Lung Cancer Advances in Radiation Oncology |
| title | Prognostic Value of Early Fluorodeoxyglucose-Positron Emission Tomography Response Imaging and Peripheral Immunologic Biomarkers: Substudy of a Phase II Trial of Risk-Adaptive Chemoradiation for Unresectable Non-Small Cell Lung Cancer |
| title_full | Prognostic Value of Early Fluorodeoxyglucose-Positron Emission Tomography Response Imaging and Peripheral Immunologic Biomarkers: Substudy of a Phase II Trial of Risk-Adaptive Chemoradiation for Unresectable Non-Small Cell Lung Cancer |
| title_fullStr | Prognostic Value of Early Fluorodeoxyglucose-Positron Emission Tomography Response Imaging and Peripheral Immunologic Biomarkers: Substudy of a Phase II Trial of Risk-Adaptive Chemoradiation for Unresectable Non-Small Cell Lung Cancer |
| title_full_unstemmed | Prognostic Value of Early Fluorodeoxyglucose-Positron Emission Tomography Response Imaging and Peripheral Immunologic Biomarkers: Substudy of a Phase II Trial of Risk-Adaptive Chemoradiation for Unresectable Non-Small Cell Lung Cancer |
| title_short | Prognostic Value of Early Fluorodeoxyglucose-Positron Emission Tomography Response Imaging and Peripheral Immunologic Biomarkers: Substudy of a Phase II Trial of Risk-Adaptive Chemoradiation for Unresectable Non-Small Cell Lung Cancer |
| title_sort | prognostic value of early fluorodeoxyglucose positron emission tomography response imaging and peripheral immunologic biomarkers substudy of a phase ii trial of risk adaptive chemoradiation for unresectable non small cell lung cancer |
| url | http://www.sciencedirect.com/science/article/pii/S2452109421002153 |
| work_keys_str_mv | AT stephenrbowenphd prognosticvalueofearlyfluorodeoxyglucosepositronemissiontomographyresponseimagingandperipheralimmunologicbiomarkerssubstudyofaphaseiitrialofriskadaptivechemoradiationforunresectablenonsmallcelllungcancer AT danielshippems prognosticvalueofearlyfluorodeoxyglucosepositronemissiontomographyresponseimagingandperipheralimmunologicbiomarkerssubstudyofaphaseiitrialofriskadaptivechemoradiationforunresectablenonsmallcelllungcancer AT hannahmthomasphd prognosticvalueofearlyfluorodeoxyglucosepositronemissiontomographyresponseimagingandperipheralimmunologicbiomarkerssubstudyofaphaseiitrialofriskadaptivechemoradiationforunresectablenonsmallcelllungcancer AT balukrishnasasidharanmbbsmddnbdmrt prognosticvalueofearlyfluorodeoxyglucosepositronemissiontomographyresponseimagingandperipheralimmunologicbiomarkerssubstudyofaphaseiitrialofriskadaptivechemoradiationforunresectablenonsmallcelllungcancer AT pauldlampephd prognosticvalueofearlyfluorodeoxyglucosepositronemissiontomographyresponseimagingandperipheralimmunologicbiomarkerssubstudyofaphaseiitrialofriskadaptivechemoradiationforunresectablenonsmallcelllungcancer AT christinasbaikmdmph prognosticvalueofearlyfluorodeoxyglucosepositronemissiontomographyresponseimagingandperipheralimmunologicbiomarkerssubstudyofaphaseiitrialofriskadaptivechemoradiationforunresectablenonsmallcelllungcancer AT keithdeatonmdphd prognosticvalueofearlyfluorodeoxyglucosepositronemissiontomographyresponseimagingandperipheralimmunologicbiomarkerssubstudyofaphaseiitrialofriskadaptivechemoradiationforunresectablenonsmallcelllungcancer AT sylvialeemd prognosticvalueofearlyfluorodeoxyglucosepositronemissiontomographyresponseimagingandperipheralimmunologicbiomarkerssubstudyofaphaseiitrialofriskadaptivechemoradiationforunresectablenonsmallcelllungcancer AT renatogmartinsmdmph prognosticvalueofearlyfluorodeoxyglucosepositronemissiontomographyresponseimagingandperipheralimmunologicbiomarkerssubstudyofaphaseiitrialofriskadaptivechemoradiationforunresectablenonsmallcelllungcancer AT rafaelsantanadavilamd prognosticvalueofearlyfluorodeoxyglucosepositronemissiontomographyresponseimagingandperipheralimmunologicbiomarkerssubstudyofaphaseiitrialofriskadaptivechemoradiationforunresectablenonsmallcelllungcancer AT delphinelchenmd prognosticvalueofearlyfluorodeoxyglucosepositronemissiontomographyresponseimagingandperipheralimmunologicbiomarkerssubstudyofaphaseiitrialofriskadaptivechemoradiationforunresectablenonsmallcelllungcancer AT paulekinahanphd prognosticvalueofearlyfluorodeoxyglucosepositronemissiontomographyresponseimagingandperipheralimmunologicbiomarkerssubstudyofaphaseiitrialofriskadaptivechemoradiationforunresectablenonsmallcelllungcancer AT robertsmiyaokaphd prognosticvalueofearlyfluorodeoxyglucosepositronemissiontomographyresponseimagingandperipheralimmunologicbiomarkerssubstudyofaphaseiitrialofriskadaptivechemoradiationforunresectablenonsmallcelllungcancer AT hubertjvessellemdphd prognosticvalueofearlyfluorodeoxyglucosepositronemissiontomographyresponseimagingandperipheralimmunologicbiomarkerssubstudyofaphaseiitrialofriskadaptivechemoradiationforunresectablenonsmallcelllungcancer AT amcgarryhoughtonmd prognosticvalueofearlyfluorodeoxyglucosepositronemissiontomographyresponseimagingandperipheralimmunologicbiomarkerssubstudyofaphaseiitrialofriskadaptivechemoradiationforunresectablenonsmallcelllungcancer AT rameshrenganmdphd prognosticvalueofearlyfluorodeoxyglucosepositronemissiontomographyresponseimagingandperipheralimmunologicbiomarkerssubstudyofaphaseiitrialofriskadaptivechemoradiationforunresectablenonsmallcelllungcancer AT jingzengmd prognosticvalueofearlyfluorodeoxyglucosepositronemissiontomographyresponseimagingandperipheralimmunologicbiomarkerssubstudyofaphaseiitrialofriskadaptivechemoradiationforunresectablenonsmallcelllungcancer |